Aspergillosis - Revision history

Elcatracho: /* External Links */

2021-03-08T03:49:43Z

External Links

← Older revision		Revision as of 03:49, 8 March 2021
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	==External Links==		==External Links==
	*http://www.cdc.gov/fungal/diseases/aspergillosis/index.html?s_cid=cs_748		*[http://www.cdc.gov/fungal/diseases/aspergillosis/index.html?s_cid=cs_748 CDC: Aspergillosis]

	==References==		==References==

Elcatracho: /* See Also */

2021-03-08T03:49:13Z

ClaireLewis at 20:31, 24 August 2019

2019-08-24T20:31:13Z

← Older revision		Revision as of 20:31, 24 August 2019
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	===Allergic Bronchopulmonary Aspergillosis (ABPA)===		===Allergic Bronchopulmonary Aspergillosis (ABPA)===
	*Hypersensitivity reaction to ''A fumigatus''		*Hypersensitivity reaction to ''A fumigatus''
	*Asthma and cystic fibrosis		*[[Asthma]] and [[cystic fibrosis]]
	*Cough, mucous plugs, bronchial casts, [[hemoptysis]], wheezing		*[[Cough]], mucous plugs, bronchial casts, [[hemoptysis]], [[wheezing]]
	*+/- Allergic fungal sinusitis		*+/- Allergic fungal sinusitis
	===Chronic Necrotizing Aspergillosis Pneumonia (CNPA)===		===Chronic Necrotizing Aspergillosis Pneumonia (CNPA)===
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	===Invasive aspergillosis===		===Invasive aspergillosis===
	*[[Neutropenia]] or immunosuppression		*[[Neutropenia]] or immunosuppression
	*Organ transplantation (bone marrow), leukemia, lymphoma, chemotherapy		*Organ [[transplant complications\|transplantation]] (bone marrow), [[leukemia]], [[lymphoma]], chemotherapy
	*Long-term steroid use (ex [[COPD]])		*Long-term steroid use (ex [[COPD]])
	*[[Fever]], cough, dyspnea, pleuritic [[chest pain]], [[hemoptysis]]		*[[Fever]], cough, dyspnea, pleuritic [[chest pain]], [[hemoptysis]]
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	**Precipitin Ab test +		**Precipitin Ab test +
	**[[CXR]]/CT: Mass in preexisting cavity, often in upper lobe (crescent of air outlining solid mass)		**[[CXR]]/CT: Mass in preexisting cavity, often in upper lobe (crescent of air outlining solid mass)
	*Invasive ~~apsergillosis~~ and CNPA		*Invasive aspergillosis and CNPA
	**Visualization of fungi (Silver stain)		**Visualization of fungi (Silver stain)
	**Positive culture from sputum, needle biopsy, or BAL		**Positive culture from sputum, needle biopsy, or BAL
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	**[[CXR]]: Nodules, cavitary lesions, alveolar infiltrates		**[[CXR]]: Nodules, cavitary lesions, alveolar infiltrates
	**CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction		**CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction

			===Special Population: [[Cystic Fibrosis]]===
			*Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate
			*Treatment: New radiologic finding and symptoms and change in baseline IgE >500 IU/mL

	==Management==		==Management==
	*Pulmonary consult +/- ID consult		*Pulmonary consult +/- ID consult
	*ABPA: Oral corticosteroids		*ABPA: Oral [[corticosteroids]]
	**Recurrent chronic, add oral [[itraconazole]] +/- surgical resection of nasal polyp		**Recurrent chronic, add oral [[itraconazole]] +/- surgical resection of nasal polyp
	*Aspergilloma		*Aspergilloma
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	**Bronchial artery embolization		**Bronchial artery embolization
	*Invasive aspergillosis		*Invasive aspergillosis
	**Voriconazole DOC		**[[Voriconazole]] DOC
	**Alternative: Posaconazole, amphotericin B, caspofungin		**Alternative: Posaconazole, [[amphotericin B]], [[caspofungin]]
	**Reduce immunosuppression		**Reduce immunosuppression
	*CNPA		*CNPA
	**Voriconazole, itraconazole, ~~caspogungin~~, or amphotericin		**[[Voriconazole]], [[itraconazole]], [[caspofungin]], or [[amphotericin b]]
	**Reduce immunosuppression		**Reduce immunosuppression

	~~==Special Population: [[Cystic Fibrosis]]==~~
	*Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate
	*Treatment: New radiologic finding and symptoms and change in baseline IgE >500 IU/mL

	==Disposition==		==Disposition==

ClaireLewis: /* Differential Diagnosis */

2019-08-24T20:28:15Z

Differential Diagnosis

← Older revision		Revision as of 20:28, 24 August 2019
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Asthma]]		*[[Asthma]]
	*~~bronchiectasis~~		*[[Bronchiectasis]]
	*[[Eosinophilia]]		*[[Eosinophilia]]
	*[[ARDS]]		*[[ARDS]]

Rossdonaldson1: Text replacement - "CXR" to "CXR"

2016-09-09T08:45:14Z

Text replacement - "*CXR" to "*CXR"

← Older revision		Revision as of 08:45, 9 September 2016
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	**Aspergillus precipitins +		**Aspergillus precipitins +
	**Aspergillus radioallergosorbent assay test + and sputum culture		**Aspergillus radioallergosorbent assay test + and sputum culture
	**CXR: Fleeting pulmonary infiltrates, mucoid impaction, central bronchiectasis		**[[CXR]]: Fleeting pulmonary infiltrates, mucoid impaction, central bronchiectasis
	**CT chest: Bronchiectasis, lobulated masses that are mucus-filled dilate bronchi		**CT chest: Bronchiectasis, lobulated masses that are mucus-filled dilate bronchi
	*Aspergilloma		*Aspergilloma
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	**Positive culture from sputum, needle biopsy, or BAL		**Positive culture from sputum, needle biopsy, or BAL
	**Galactomannan level		**Galactomannan level
	**CXR: Nodules, cavitary lesions, alveolar infiltrates		**[[CXR]]: Nodules, cavitary lesions, alveolar infiltrates
	**CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction		**CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T19:52:50Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 19:52, 23 July 2016
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	{{Causes of pneumonia}}		{{Causes of pneumonia}}

	==~~Diagnosis~~==		==Evaluation==
	*ABPA		*ABPA
	**[[Eosinophilia]]		**[[Eosinophilia]]

Neil.m.young: Text replacement - "* " to "*"

2016-07-07T06:04:52Z

Text replacement - "* " to "*"

← Older revision		Revision as of 06:04, 7 July 2016
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	==Background==		==Background==
	* Primary affects lung		*Primary affects lung
	* [[Mold]]: Hyphae that branches 45°		*[[Mold]]: Hyphae that branches 45°
	* Inhalation		*Inhalation

	==Clinical Features==		==Clinical Features==
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	==Differential Diagnosis==		==Differential Diagnosis==
	* [[Asthma]]		*[[Asthma]]
	*bronchiectasis		*bronchiectasis
	*[[Eosinophilia]]		*[[Eosinophilia]]
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	==Diagnosis==		==Diagnosis==
	* ABPA		*ABPA
	** [[Eosinophilia]]		**[[Eosinophilia]]
	** Skin test + for ''A. Fumigatus''		**Skin test + for ''A. Fumigatus''
	** Serum IgE > 1000 IU/dL or > x 2-fold rise from baseline		**Serum IgE > 1000 IU/dL or > x 2-fold rise from baseline
	** Aspergillus precipitins +		**Aspergillus precipitins +
	** Aspergillus radioallergosorbent assay test + and sputum culture		**Aspergillus radioallergosorbent assay test + and sputum culture
	** CXR: Fleeting pulmonary infiltrates, mucoid impaction, central bronchiectasis		**CXR: Fleeting pulmonary infiltrates, mucoid impaction, central bronchiectasis
	** CT chest: Bronchiectasis, lobulated masses that are mucus-filled dilate bronchi		**CT chest: Bronchiectasis, lobulated masses that are mucus-filled dilate bronchi
	* Aspergilloma		*Aspergilloma
	** Precipitin Ab test +		**Precipitin Ab test +
	** [[CXR]]/CT: Mass in preexisting cavity, often in upper lobe (crescent of air outlining solid mass)		**[[CXR]]/CT: Mass in preexisting cavity, often in upper lobe (crescent of air outlining solid mass)
	* Invasive apsergillosis and CNPA		*Invasive apsergillosis and CNPA
	** Visualization of fungi (Silver stain)		**Visualization of fungi (Silver stain)
	** Positive culture from sputum, needle biopsy, or BAL		**Positive culture from sputum, needle biopsy, or BAL
	** Galactomannan level		**Galactomannan level
	** CXR: Nodules, cavitary lesions, alveolar infiltrates		**CXR: Nodules, cavitary lesions, alveolar infiltrates
	** CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction		**CT chest: Halo sign, screscent of air surrounding nodules, wedge-shaped or pleural-based infiltrates, cavitation, pulmonary infarction

	==Management==		==Management==
	* Pulmonary consult +/- ID consult		*Pulmonary consult +/- ID consult
	* ABPA: Oral corticosteroids		*ABPA: Oral corticosteroids
	** Recurrent chronic, add oral [[itraconazole]] +/- surgical resection of nasal polyp		**Recurrent chronic, add oral [[itraconazole]] +/- surgical resection of nasal polyp
	* Aspergilloma		*Aspergilloma
	** Symptomatic ([[hemoptysis]]): Oral [[itraconazole]]		**Symptomatic ([[hemoptysis]]): Oral [[itraconazole]]
	** Intracavitary CT-guided percutaneous catheter px for [[amphotericin B]]		**Intracavitary CT-guided percutaneous catheter px for [[amphotericin B]]
	** Surgical resection		**Surgical resection
	** Bronchial artery embolization		**Bronchial artery embolization
	* Invasive aspergillosis		*Invasive aspergillosis
	** Voriconazole DOC		**Voriconazole DOC
	** Alternative: Posaconazole, amphotericin B, caspofungin		**Alternative: Posaconazole, amphotericin B, caspofungin
	** Reduce immunosuppression		**Reduce immunosuppression
	* CNPA		*CNPA
	** Voriconazole, itraconazole, caspogungin, or amphotericin		**Voriconazole, itraconazole, caspogungin, or amphotericin
	** Reduce immunosuppression		**Reduce immunosuppression

	==Special Population: [[Cystic Fibrosis]]==		==Special Population: [[Cystic Fibrosis]]==
	* Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate		*Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate
	* Treatment: New radiologic finding and symptoms and change in baseline IgE >500 IU/mL		*Treatment: New radiologic finding and symptoms and change in baseline IgE >500 IU/mL

	==Disposition==		==Disposition==
	* Invasive aspergillosis often requires admission		*Invasive aspergillosis often requires admission
	* Admit if massive hemoptysis		*Admit if massive hemoptysis
	* ABPA usually managed outpatient		*ABPA usually managed outpatient

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>
	* Harman EM, et al. (2014, May 31). Aspergillosis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/296052-overview		*Harman EM, et al. (2014, May 31). Aspergillosis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/296052-overview

	[[Category:ID]]		[[Category:ID]]

Neil.m.young: Text replacement - "sxs " to "symptoms "

2016-07-04T17:02:50Z

Text replacement - "sxs " to "symptoms "

← Older revision		Revision as of 17:02, 4 July 2016
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	==Special Population: [[Cystic Fibrosis]]==		==Special Population: [[Cystic Fibrosis]]==
	* Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate		* Diagnosis: Clinical deterioration; IgE> 1000IU/mL or > 2-4x baseline; + serology; new infiltrate
	* Treatment: New radiologic finding and ~~sxs~~ and change in baseline IgE >500 IU/mL		* Treatment: New radiologic finding and symptoms and change in baseline IgE >500 IU/mL

	==Disposition==		==Disposition==

Rossdonaldson1: /* Syndromes */

2016-06-05T13:35:55Z

Syndromes

← Older revision		Revision as of 13:35, 5 June 2016
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	* [[Mold]]: Hyphae that branches 45°		* [[Mold]]: Hyphae that branches 45°
	* Inhalation		* Inhalation

	~~===Syndromes===~~
	* Allergic Bronchopulmonary Aspergillosis (ABPA)
	* Chronic Necrotizing Aspergillosis Pneumonia (CNPA)
	* Aspergilloma
	* Invasive aspergillosis

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Background */

2016-06-05T13:35:36Z

Background

← Older revision		Revision as of 13:35, 5 June 2016
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	* [[Mold]]: Hyphae that branches 45°		* [[Mold]]: Hyphae that branches 45°
	* Inhalation		* Inhalation
	* 4 syndromes:
	** Allergic Bronchopulmonary Aspergillosis (ABPA)		===Syndromes===
	** Chronic Necrotizing Aspergillosis Pneumonia (CNPA)		* Allergic Bronchopulmonary Aspergillosis (ABPA)
	** Aspergilloma		* Chronic Necrotizing Aspergillosis Pneumonia (CNPA)
	** Invasive aspergillosis		* Aspergilloma
			* Invasive aspergillosis

	==Clinical Features==		==Clinical Features==

← Older revision		Revision as of 03:49, 8 March 2021
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	==See Also==		==See Also==
	*[[Fungal infections]]		*[[Fungal infections]]
			*[[Antifungals]]

	==External Links==		==External Links==